Late-onset systemic lupus erythematosus can present atypically with massive pericardial effusion and cardiorenal syndrome, highlighting the importance of considering autoimmune etiologies in elderly patients with these findings.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by inflammation and immune-mediated damage with mucocutaneous, musculoskeletal, cardiopulmonary, and renal involvement. It typically affects younger women; however, late-onset presentations can occur and often display distinct clinical features. We report the case of a septuagenarian woman who presented with massive pericardial effusion and type 3 cardiorenal syndrome. Further evaluation revealed class IV lupus nephritis, confirming a diagnosis of late-onset SLE according to the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria. Cardiac and serous membrane involvement is more common in late-onset SLE than in classical SLE.
Angulo et al. (Thu,) studied this question.